Exploring the Functional Impact of Childhood Vision Impairment: An e-Delphi Study

The principles of the World Health Organization's International Classification of Function, Disability and Health have been embraced globally as a framework to support people with disability. This framework recognizes the functional needs of a person, as well as their medical diagnosis. However, the challenge of assessing the functional impact of disability to determine a person's needs and eligibility for support remains an issue. One example is that of childhood vision impairment, where a child's eligibility is often gauged from their visual performance in a clinical environment, a setting that is far removed from the child's real-world environment. Such clinical environments fail to reveal those factors that have a functional impact and affect the child's continuous visual function in their everyday situation. To examine this issue a three round modified e-Delphi technique was applied to explore the functional impact of childhood vision impairment. A panel of experienced Australian orthoptists and specialist teachers in vision impairment was convened, and the recently revised vision classifications in the World Health Organization International Statistical Classification of Diseases and Health Related Problems Version 11 were reviewed and modified for their application to children. This paper describes the e-Delphi technique and the major study outcomes including the modifications proposed by the study's participants, and the emerging paradigm that progresses an understanding of the functional impact of childhood vision impairment.